This study will provide rigorous evaluation of implementing a virtual genome center into community clinical settings without highly specialized resources, thereby offering generalizable insights as to how best to implement genomic medicine at scale and for other age groups. This intervention has great potential to address disparities in genomic medicine among low-income and underrepresented minority (URM) populations and will enhance capacity for providers and health systems to utilize highly specialized genomic techniques in their communities. The goal of this study is to achieve equitable access to state-of-the-art genomic medical care to sick newborns in community centers that predominately care for low-income and racial/ethnic minority populations through the creation of a virtual genome center (VIGOR). VIGOR will provide a venue for physician and family education, genomic expert consultation, reanalysis of unsolved sequencing data, and access to cutting edge therapeutic innovation, thereby facilitating institutionalization of genomic best practices in community settings, and not just highly specialized referral centers.
Genomic medicine has rapidly advanced in the past decade enabling earlier diagnosis and personalized treatment. However, only a few highly specialized centers in the US have the resources to take advantage of these advances in patient care. This has created a large health equity gap whereby patients cared for in typical community settings, often low-income and/or representing racial/ethnic minorities, do not receive equitable medical care. Another barrier to the wider utilization of genomic medicine is the poor dissemination of knowledge among clinicians, especially in community settings. A wide gap exists in the implementation of genomic medicine from diagnosis to personalized therapies, a field experiencing huge advances but still subject to wide disparities in accessibility. This study aims to develop and test the implementation of a strategy to break down these barriers to genomic medicine. The target population is sick newborns admitted to the NICU that present with probable genetic conditions. This study proposes a novel center, VIrtual GenOme CenteR (VIGOR). VIGOR will be a center that can remotely support clinicians and families working in community NICUs. This study will provide rigorous evaluation of implementing a virtual genome center at community clinical settings without highly specialized resources, thereby offering generalizable insights as to how best to implement genomic medicine at scale and for other age groups. This intervention has great potential to address disparities in genomic medicine among low-income and underrepresented minorities (URM) populations and will enhance capacity for providers and health systems to utilize highly specialized genomic techniques in their communities. The goal of this study is to achieve equitable access to state-of-the-art genomic medical care to sick newborns in community centers that predominately care for low-income and racial/ethnic minority populations through the creation of a virtual genome center (VIGOR). VIGOR will provide a venue for physician and family education, genomic expert consultation, reanalysis of unsolved sequencing data, and access to cutting edge therapeutic innovation, thereby facilitating institutionalization of genomic best practices in community settings, and not just highly specialized referral centers.
Study Type
OBSERVATIONAL
Enrollment
750
USA Children's and Women's Hospital
Mobile, Alabama, United States
RECRUITINGHoltz Children's Hospital at Jackson Memorial Medical Center
Miami, Florida, United States
RECRUITINGBoston Medical Center
Boston, Massachusetts, United States
RECRUITINGBaystate Medical Center
Springfield, Massachusetts, United States
RECRUITINGUMass Memorial Hospital
Worcester, Massachusetts, United States
RECRUITINGCooper University Hospital
Camden, New Jersey, United States
RECRUITINGDriscoll Children's Hospital Rio Grande Valley
Edinburg, Texas, United States
RECRUITINGThe Women's Hospital at Renaissance
Edinburg, Texas, United States
RECRUITINGThe Hospitals of Providence
El Paso, Texas, United States
RECRUITINGUniversity of Texas Medical Branch
Galveston, Texas, United States
RECRUITINGImplementation of VIGOR
Penetration of VIGOR measured by percentage of eligible participants who were enrolled, tested, providers received CIR and completed a disclosure session.
Time frame: 4 year
Implementation of VIGOR
Appropriateness of VIGOR measured at the provider level by conducting focus groups/interviews.
Time frame: 4 year
Implementation of VIGOR
Feasibility of VIGOR measured at the provider level by conducting focus groups/interviews.
Time frame: 4 year
Service Outcomes
Equity in penetration of VIGOR use by race/ethnicity, insurance status and primary language measured at the participant level by conducting chart reviews and surveys.
Time frame: 4 years
Client Outcomes
Function measured at the infant/caregiver and provider level by conducting surveys, chart reviews and focus groups/interviews.
Time frame: 4 years
Client Outcomes
Symptomatology measured at the infant/caregiver level by conducting surveys, and interviews.
Time frame: 4 years
Client Outcomes
Satisfaction measured at the infant/caregiver and provider level by conducting surveys, chart reviews and focus groups/interviews.
Time frame: 4 years
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